Prevalence of Pruritus in the Elderly with Dementia: A Multicenter Survey of Japanese Patients.

A total of 185 elderly Japanese patients with mild to severe dementia were surveyed on itch, using multiple methods of evaluation including self-evaluation of itch conducted by patients as well as evaluation of scratching behavior and scratching marks on the body surface conducted by others. As a result, 36.8% self-evaluated that they were suffering from itch, whereas 53.5% were found to scratch. Of those who by themselves denied the presence of itch, 31.4% were found to scratch. Dry skin was found in 74.1%, the severity of which was positively correlated to the rating of scratching behavior and marks. These results indicate a high prevalence of pruritus in patients with dementia, and suggest that one should not solely rely on self-evaluation but should refer to additional clinical information such as scratching for evaluation of pruritus in patients with dementia. Skin care with moisturizer may be important to control itch in patients with dementia.

Measurement of Nocturnal Scratching in Patients with Pruritus Using a Smartwatch: Initial Clinical Studies with the Itch Tracker App.

Three clinical studies were conducted to test a newly-developed app for smartwatches, which included an algorithm to measure nocturnal scratching using acceleration data. The first study in 5 patients with atopic dermatitis demonstrated high reliability of the app for measurement of scratching compared with video monitoring (positive predictive value 90.2 ± 6.6%, sensitivity 84.6 ± 10.2%, correlation of scratching duration per h r = 0.851-0.901, p < 0.001). The second study in 20 patients with atopic dermatitis and 10 healthy volunteers showed that total scratching duration in patients was significantly longer than in healthy volunteers and correlated positively with Eczema Area and Severity Index (EASI) scores. In the third study, conducted in an open-entry manner in which 201 evaluable participants measured nocturnal scratching, those who self-reported itch or pruritic diseases had a significantly longer duration of scratching than those who did not. In conclusion, this app has a high reliability and potential clinical usefulness for measurement of nocturnal scratching.

Safe and effective deodorization of malodorous fungating tumors using topical metronidazole 0.75 % gel (GK567): a multicenter, open-label, phase III study (RDT.07.SRE.27013).

PURPOSE: Malignant fungating tumors are neoplastic tumors associated with skin ulcers, which are susceptible to microbial colonization. Bacterial infection and proliferation may lead to malodor causing distress to patients. Metronidazole-an effective agent against anaerobes-may contribute to deodorization and improvement in quality of life (QOL). This study investigated the efficacy and safety of topical metronidazole 0.75 % gel for alleviation of malodor in anaerobically infected fungating neoplastic tumors. METHODS: This was a multicenter, open-label, non-controlled, phase III study including subjects aged 20 years or older with cutaneous fungating tumors releasing malodor (minimum score of 2 (mildly offensive smell) on a scale from 0 (no smell) to 4 (extremely offensive smell) based on investigator's assessment). Subjects applied metronidazole 0.75 % gel once or twice daily at the investigator's discretion for 14 days. Success was defined as an odor score of 0 or 1 at day 14, as assessed by the investigator. Patient satisfaction was assessed using a satisfaction questionnaire. Adverse events (AEs) that occurred after application of metronidazole 0.75 % gel were also reported. RESULTS: A total of 21 subjects at a median age of 65.0 years were enrolled. The success rate of deodorization at day 14 was 95.2 % (20/21 subjects). The patient satisfaction assessment showed that 71.4 % (15/21) of subjects were markedly or moderately improved. The treatment was well tolerated with only two AE cases of skin neoplasm bleeding (one mild and one moderate). CONCLUSIONS: Metronidazole 0.75 % gel is an effective and safe treatment for deodorization of malodorous fungating tumors.